


Occam's Razor

by kaianieves



Series: Wayward Med [2]
Category: Supernatural
Genre: Alternate Universe - Hospital, F/F, Implied/Referenced Abuse, Implied/Referenced Alcohol Abuse/Alcoholism, Implied/Referenced Drug Use, Medical Procedures, Nothing Changed Except Patience is a Medical Student Now, medical student
Language: English
Status: Completed
Published: 2020-02-04
Updated: 2020-02-04
Packaged: 2021-02-28 02:26:42
Rating: Teen And Up Audiences
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 2,481
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/22556287
Author URL: https://archiveofourown.org/users/kaianieves/pseuds/kaianieves
Summary: Swiping her keycard through the card reader, Patience stood back and waited for the light to turn green. Instead, it stayed red. She tried again. Still red. Again. Nothing.“Come on,” she mumbled. Patience swiped again. The door stayed locked. She looked at her watch. Three minutes until her shift started. “Please.”“Need some help?” Patience turned to see Alex standing in front of the elevator, a coffee in her hand.-A patient comes in with strange purple bumps on her skin. Alex cares for an old friend.
Relationships: Alex Jones & Patience Turner, Alex Jones/Patience Turner
Series: Wayward Med [2]
Series URL: https://archiveofourown.org/series/1619257
Comments: 2
Kudos: 5





	Occam's Razor

**Author's Note:**

> The latter two of the implied/referenced tags are characters speculating and trying to diagnose a patient.

The bus was hot, Patience’s hand sticking to the metal pole as she held onto it. A woman stood across from her, stroller sitting in front of her. A baby was staring up at Patience, eyes wide, a pacifier in his mouth.

She smiled, waving her hand. His mother made eye contact. “His name is Bo,” she said. “I’m Lilly.”

“He’s adorable,” Patience said.

“Thank you.” Lilly looked at Patience’s clothes, eyes catching on the logo embroidered on the sleeve of her sweater. “Are you a doctor?”

Patience always got this question when she wore her hospital sweater. It was a fairly new experience, since she’d only gotten it when she started her third year. It never failed to make her uncomfortable, though. You never knew how someone would react when you said the inevitable: No, not yet. Sometimes they’d congratulate you. Other times they’d dismiss you, which never failed to confuse Patience.

“Med student. Third year,” she said.

“Oh, well congratulations,” Lilly said.

“Thanks.”

The bus halted quickly to a stop. Patience looked out the window, past the head of the man sitting with bulky headphones over his beanie. The hospital sat squarely across the street from where they were stopped.

“Goodbye,” Patience said quietly, looking down at the baby. He moved his tiny hand forward, almost like he was reaching out. Then she looked up. “Have a good morning, ma’am.” She almost had to elbow her way to the doors, stepping out into the cold.

The bus pulled away slowly. Patience pulled her scarf over her nose, trying to avoid breathing in the exhaust. When the crosswalk signaled it was her turn to walk, she hurried across the road, cars idling beside her at the red light.

Patients stood outside the hospital’s main entrance, some standing next to IV poles carrying bags of fluids as they smoked. Inside the hospital almost seemed colder than outside. She turned the corner, walking to the staff entrance. Swiping her key card through the card reader, Patience stood back and waited for the light to turn green. Instead, it stayed red. She tried again. Still red. Again. Nothing.

“Come on,” she mumbled. Patience swiped again. The door stayed locked. She looked at her watch. Three minutes until her shift started. “Please.”

“Need some help?” Patience turned to see Alex standing in front of the elevator, a coffee in her hand.

“My card isn’t working,” she explained.

“No problem,” Alex said. She moved forward, swiping her card through. The light turned green, the lock on the door audibly clicking open. She turned the handle, pushing it open and holding it.

“Thanks. You just saved my ass,” Patience said.

“It’s not like they can fire you,” Alex said.

“You’d be surprised.”

They both stopped at the staff lockers, Patience crouching down to unlock hers. She got out her lab coat, unfolding it and smoothing it out against her leg.

“The coat looks nice on you,” Alex said, taking a sip of her coffee.

Patience snorted quietly. “I guess.”

“Seriously,” Alex insisted. “If it wasn’t for the label, I’d think you’re an M.D..”

“That day is a long time and many student loans away,” Patience said. “I didn’t know you were working today.”

“And it’s actually my scheduled shift this time,” Alex said, which made Patience confused. She didn’t seem to notice, continuing. “I’m full time, so I’m here almost every day. Sometimes Doris likes to stick me behind a desk.”

“Paperwork duty?”

“For almost twelve hours,” Alex confirmed.

Their conversation was interrupted by the door opening. Dr. Guerrera walked in, backpack over his shoulder. “Dr. Turner, Nurse Jones. Morning,” he said. He left his bag on the lay-z-boy recliner, walking between them to the door that lead to the main unit.

“Sometimes I second guess my choice of profession,” Patience said once the door closed.

“There would be guys like that even if you went into accounting,” Alex said. “Don’t let Guerrera get on you. He thinks he’s God, but he’s just a doctor.”

“I’ll keep that in mind.”

“Dr. Turner, you’re with me,” Dr. Guerrera said. “We’ve got a case. 32 year old woman, Carmen Salazar came in this morning with purple welts all over her skin.”

“Are we suspecting abuse?” Patience asked.

“No, Dr. Turner. More like a bad skin rash. A reaction to soap, perhaps,” he said.

“Sorry. Just when I hear welts--”

“Both as a doctor and as a human being, you’re going to have to learn a very important lesson, Dr. Turner. Occam’s razor,” Dr. Guerrera said.

“All things being equal, the simplest solution tends to be the best one,” she said. “I took tenth grade English class, Dr. Guerrera.” Patience pulled the curtain open to the treatment room, revealing a woman laying on the bed. Her arms were covered in purplish-red lumps. Her eyes were closed, sweat beading her forehead. “Was she like this before?”

“No,” Dr. Guerrera said. “Her arms look like they’re bruising.”

“Ms. Salazar, can you hear me? Have you taken any medications?” Patience turned to Dr. Guerrera. “Does she have any prescriptions? Corticosteroids could weaken the blood vessels and increase her chances of bleeding,” Patience said.

“There’s nothing in her history. Order a lab and an MRE. Could very well be cirrhosis.”

“Yes, doctor,” Patience said.

Alex was beside the paramedic gurney as it burst in through the ED doors. The patient’s face was covered by an oxygen mask, obscuring it. “Dr. Arom, we need you over here!” she yelled.

The patient started thrashing, arms moving around sporadically. Alex held them down at their sides. “You’re going to Treatment 3,” Doris said.

Dr. Arom joined Alex and the paramedics in the treatment room. “Status?” she asked.

“Seventeen year old male found on the floor at a house party. Looks like his boys left him when the cops busted it. He was unconscious when we got there. He’s been rotating between unconsciousness and psychosis since we loaded him in the van.”

Alex removed the mask, making direct eye contact with the patient. “Alex!” he yelled. “Alex you gotta’ help me! The blood! You’ve gotta’ get the blood off of me!”

“You know him?” Dr. Arom asked.

“His name is Tyler Waites. We went to high school together,” Alex said quickly.

“You going to be able to work this case?” Dr. Arom was multitasking, placing the patient’s hands in restraints.

“We weren’t friends.”

“Alright then. Nurse Jones, three milligrams of Haldol,” Dr. Arom said. Alex stuck a sanitary syringe into a bottle, trying to find a vein. Tyler wouldn’t keep still.

“He won’t stay still,” Alex said. Finally she was able get his arm stable, holding it down as she stuck the needle in. Moments later, he started to calm down.

Dr. Arom was finally able to do a proper exam, opening his eyelids and shining a flashlight at them. “His pupils are staying dilated. Get a blood test done. Along with the psychosis, I’m guessing LSD,” she said.

“Where would he have gotten that here?” Alex asked.

“You’d be surprised, Dr. Jones.”

Patience sat at the computer in the staff room, staring at the bright screen. She didn’t notice the door open, much less Alex come in and make a bee line for the fridge.

“What are you doing?” she asked.

Patience turned in her chair. “Oh, hey. Research, I guess? It’s one of my patients. Her case is really… bizarre.”

Alex grabbed a handful of baby carrots from her lunch. “What are her symptoms?”

“Purple bumps all over her skin, it sort of looks like bruising in some areas. Along her arms especially. According to Dr. Guerrera they got worse between the time he checked her in and I arrived, but she’s not on any medications.”

“Could be non-prescription,” Alex said.

“She seems like a regular middle class person, though,” Patience said.

“I’ve got a patient right now in a state of psychosis because of LSD. You never know with the cases in here. Maybe she’s an alcoholic with liver disease?”

“That’s the diagnosis Guerrera’s pursuing, but I don’t know. It doesn’t add up. She didn’t have any traces of alcohol in her system and nothing came up on her MRE,” Patience said. “You know he tried to quote Occam’s razor to me? ‘Cause at first I thought our patient was an abuse victim.”

“Of course he did,” Alex said. She bit down on another carrot. “Not even the health and safety of his patients can cause Dr. Guerrera pause on being a jackass.”

Patience focused back on the computer, editing her search. Alex watched over her shoulder. Something new popped up this time. “Necrotizing fasciitis. Flesh-eating bacteria?”

“That’s extremely rare.”

“I know. It’s a form of sepsis. She does have the symptoms though. The bumps, lightheadedness and sweating.” She seemed to have an epiphany. “I need you to do something for me,” Patience said.

“Okay,” Alex said, mouth full.

“That technically you’re not allowed to do.” Alex gave her a disparaging look. “I need you to look at my patient’s medical records. If she’s gotten in an accident or given birth recently, then that would explain the necrotizing fasciitis.”

“Patience…”

“Dr. Guerrera will never believe me. Alex, she could die. It’s possibly already too late. Please.” She stood up from the computer chair.

“Fine,” Alex said. She took Patience’s seat at the computer, logging in and pulling up the hospital database. “What’s your patient’s name?” Patience didn’t say anything. “What, you’re having me do this and you’re still worried about violating HIPAA?”

“Carmen Salazar.”

Alex typed the name in quickly, scrolling until she found what she was looking for. “She had a breast biopsy here three days ago.”

“Bingo. Surgery. That’s when the transfer of bacteria happened,” Patience said.

“So what do you do now?” Alex asked.

“Call the CDC, put her in quarantine. Pray to whatever god that I don’t lose my patient.” Patience walked out of the staff room, eyes on the prize. “Dr. Guerrera!” she called when she spotted him.

“Yes, Dr. Turner. Do you those lab results for me?” he asked.

“No. I know what’s going on with Ms. Salazar. It’s necrotizing fasciitis,” she said.

“That’s highly implausible, Dr. Turner,” Dr. Guerrera said.

“No, it’s not. She had a breast biopsy here at the hospital three days ago and that’s how the bacteria got into her system- a biopsy that you failed to mention, by the way. It’s not cirrhosis, she’s not a drunk. The more time we wait the more her life is in danger.”

“How are you sure--”

“If you don’t call the CDC, I will,” Patience said.

“Fine. Nurse Jackson, Nurse Jones we need Carmen Salazar put into quarantine protocol. I have to go make a phone call,” he said.

Alex walked past Patience beside Doris, giving her a brief look of approval before disappearing with Ms. Salazar.

After putting Carmen Salazar in quarantine, Alex returned to the ED, where Tyler Waites was awaiting her.

“Tyler,” she said, approaching the bed.

“Alex. Long time no see,” he said.

“Yeah. Wish it was under better circumstances, huh?” He looked down at his chest. “LSD? Really, Tyler?”

“I get it, okay?” he said. “You don’t have to give me the after-school special.”

“Maybe I do,” Alex said. “You came in here, psychotic and dangerous. You could’ve hurt yourself or someone else. How do you think Jody would feel if I told her about this?”

Alex remembered who Tyler was in high school. Vividly how they met. A poor, pale boy who’d been the victim of a vampire, who was slowly but surely turning into one, too. Jody and Alex had helped him find and take the cure. Four years later, here he was.

“Please don’t do that,” Tyler said.

“I can’t. And I wouldn’t even if I could. It wouldn’t do Jody any good,” she said. “Why?”

“Are we really doing this right now? Don’t you have a job to do? Check people’s pulses or whatever,” he said.

“Fine.” Alex grabbed his wrist, placing two fingers against his pulse point. She looked up at the monitor. “Heart rate is steady, 75 beats per minute.” She checked his IV drip, still waiting.

“I can’t stop seeing it,” he eventually said. “Him. All the blood. And the thoughts… I can’t stop thinking of myself as a monster. I try to cope with it. Taking the vampire cure isn’t exactly something you can go to a therapist about.”

“This isn’t going to help you get better,” Alex said.

“And what is?” he asked. “Please, Alex. Tell me, does everything just bounce off of you like it’s never existed? You wanna’ share your enlightened mindset with me?” Alex didn’t say anything. “Look, I’m really tired, so…”

Tyler rolled over on his side, facing away from her. Alex stood there for another minute before she left, pulling the curtain closed behind her. She could feel her face getting warm already, the tears already on their way.

Patience stood outside, hands in her lab coat pockets. The skin on her cheeks was starting to get cold, the air frigid and icy.

The hospital doors were sliding open every few minutes, people walking in and out of the building. Some had flowers and get well balloons. Others were trying to wipe tears away from their faces as they walked out of the place their loved ones had inevitably just died. Patience stood on the sidewalk, watching it all.

It surprised her when she saw Alex rush out of the building, looking up at the people standing out here. Under her eyes was wet, her eyes red. She tried to put it all away with a smile as she approached Patience.

“Hey.”

“Hey,” Patience replied.

“I just needed some fresh air,” Alex explained.

Patience nodded. “They took my patient up to the burn unit. She’s in surgery right now,” she said.

“That’s a good thing, right?” Alex asked. She crossed her arms, staring ahead at the parking lot.

“I don’t know. It could be too late. Ms. Salazar could die and it’d be my fault.”

“You know that’s not true,” Alex said.

“How are they supposed to perform that debridement? She could lose her arms and it’ll be because I didn’t catch it in time,” Patience said.

“Dr. Guerrera has a part to play in this too.”

“But he’s not the med student, is he?”

Another cold breeze blew stray cigarette smoke in their direction. “I’ve got a kid in there that I know pretty personally. Drugs, of course. He has no intention of getting better,” Alex said.

“Why’d you take his case?” Patience asked.

“Because I thought I could convince him to do something that he doesn’t want to do. Stupidly.” Alex wiped the heel of her hand under her eyes. “We’re not going to be able to save everyone. We’re medical practitioners, not superheroes.”


End file.
